CHOLERA The acute diarrhoeal disease
Cholera is an infection of the small intestines that causes a large amount of watery diarrhoea instigated by the ingestion of food or water contaminated with the bacterium vibrio cholerae. These bacteria release a toxin that causes an increased amount of water to be released from cells that line the intestines. The increase in water produces severe diarrhoea. Cholera germs are spread when faeces from an infected person get into the water people drink, or food they eat.
On February 3, 2015, the Director of Medical Services in Kenya, Dr Nicholas Muraguri, issued a cholera outbreak alert following an increase in cases of acute watery diarrhea (AWD) in several counties in the country. Since the outbreak, more than 3,000 cases have been reported and more than 60 people have died from the disease. The risk of cholera epidemic is highest when poverty, war or natural disasters force people to live in crowded conditions without adequate sanitation.
Picking cholera symptoms
Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. They include:
Severe, watery diarrhoea
Nausea and vomiting
Stomach cramps
Feeling and being sick
Without treatment, the combination of diarrhoea and vomiting can cause a person to quickly become dehydrated. The signs of a dehydrated person are:
Rapid heart rate
Dry mucous membrane
Loss of skin elasticity (the ability to return to original position quickly if pinched)
Low blood pressure
Muscle cramps
Thirst
Shock
Cholera can be fatal if not treated early and it is therefore important to know the symptoms, take personal hygiene measures and also see a doctor as soon as possible.
Treatment of cholera
Depending on the extent of the infection, treatment can include any one, or a combination, of the following regimens:
Rehydration. The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). Although there is an ORS readily available in powder form in pharmacies, a simple salt and sugar solution will do. Boil the water, let it cool down add salt and water and drink it regularly.
Intravenous fluids.During a cholera epidemic, most people can be helped by oral rehydration alone, but severely dehydrated people may also need intravenous fluids.
Antibiotics.While antibiotics are not a necessary part of cholera treatment, some of these drugs may reduce both the amount and duration of cholera-related diarrhoea. A single dose of doxycycline (Monodox, Oracea, Vibramycin) or azithromycin (Zithromax, Zmax) may be effective.
Zinc supplements. Research has shown that zinc may decrease and shorten the duration of diarrhoea in children with cholera.
If not treated early, cholera can be fatal in a matter of hours, even in previously healthy people. Those with low immunity – such as malnourished children or people living with HIV/AIDs – are at a greater risk of death if infected.
Prevention tips
Wash hands with soap and water frequently especially after using the toilet and before handling food.
Drink only safe water, including bottled water or water you’ve boiled or disinfected yourself.
Ensure proper disposal of diapers.
Eat food that’s completely cooked and hot and avoid street vendors’ food, if possible. If you have to eat from a street vendor, ensure that it is served hot.
Avoid sushi (uncooked Japanese dish), as well as raw or improperly cooked fish and seafood of any kind.
Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and avocados. Stay away from salads and fruits that can’t be peeled, such as grapes and berries.
Be wary of dairy foods, including ice cream, which can be contaminated, and unpasteurised milk.
Expert Advice…
In case of a suspected cholera infection:
• Start giving ORS immediately; it can save the patient’s life.
• Go immediately to the nearest health facility.
• Continue giving ORS while you travel to hospital.
• If your child is breastfeeding, continue breastfeeding while you travel to hospital.
